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Is Podiatry a Problem?

by Brian Patterson » on Sep 23, 2011 27

Did you see our post yesterday?  It was about a new study’s findings that runners wearing FiveFingers were more aware of their foot position than runners wearing traditional (thick, padded) running shoes.  Shocker.

While doing a little research on that post I found something troubling.  I came across this thread on a Podiatrist’s forum about the study.  One comment from a Podiatrist really stuck out to me:

Maybe instead of looking at whether minimalist/barefoot shoes are ‘bad’ or ‘good’, we should be concentrating on pooling our thoughts on what kinds of solutions for particular injuries podiatrists are able to offer the barefoot runner who wont go back to shoes? Maybe, then..if we are unable to treat these unshod problems we can start preaching about shoes/insoles/orths?

We recently wrote a post about how one podiatrists declared FiveFingers the ‘worst shoes for your feet’.  A recent post on minimalist footwear blog Yelling-Stop pointed to another blog post by the Barefoot Professor.  The Professor came across a USA Today article where “podiatrists Kendrick Whitney and Michele Colon actually state that high heeled platforms are better for your body than ballet flats or the Vibram Fivefingers.”

These statements by Podiatrists coupled with the forum comment I highlighted above and several others on that forum seem to be leading me down a scary path…. that Podiatrists hate minimalist shoes.  Or at least, all media savvy Podiatrists hate minimalist shoes.  This may not be a surprise to a lot of you, but its a troubling fact to me.

If Not a Podiatrist, Then Who?

The reason that this is so trouble to me is… if I have a foot problem, who do I go see?  A Podiatrist is defined as a doctor who specializes in the care of the foot, ankle, and leg.  From everything I’ve read, Podiatrists stand in complete contrast to the minimalist and barefoot movement.  In fact, they couldn’t be further from it.  They love padded shoes and orthopedic inserts.

My fear is that at some point in my life I may actually have some foot or ankle injury.  If/when this happens, how do I go see a doctor who believes something fundementally different than I do?  I don’t think I could truly believe anything they say.

Do They Hate Minimalist Shoes Because They Don’t Make Money From Them?

It seems that Podiatrists make a good portion of their money from inserts, special shoes, and other products that put more “stuff” under your feet.  Minimalist shoes are, again, the complete antithesis to that.  Podiatrists stand to lose a lot of money if this minimalist footwear movement continues to grow, so are they fundamentally against minimalist shoes purely because of the financial impact?  Is this media blitz an intentional plan orchestrated by the American Podiatric Medical Association?  They’re clearly looking closely at barefoot running.

I Don’t Have the Answer, Do You?

This post isn’t to provide all of the answers, because I don’t have them.  I’m putting the questions to you, dear reader.  What are we supposed to think of Podiatrists and Podiatry?  Have all of the Podiatrists you’ve encountered been anti-barefoot and anti-FiveFingers?  If so, what type of doctor should be looking at our feet?  Let us know your thoughts and experiences in the comments below!


27 Comments

  1. Andrea

    September 23rd, 2011 at 10:50 am

    I recently suffered an ankle injury. My physio is convinced I need to change my shoes. She wants me in something stiff and controlled. I, on the other hand, believe my feet need to get stronger. She keeps asking me to bring my shoes in so she can do an assessment. I keep holding off ’cause I know she’ll HATE my vibrams/other barefoot style shoes. My experience prompted me to search for physios with barefoot experience. Very hard to locate on the internet.

    Reply

    • Danny

      March 20th, 2012 at 8:03 am

      Hi Andrea,
      Just curious, but how is your ankle progressing if you use your VFF? Does your ankle feel better?
      In “physio land” there is a lot of resistance about using VFF or going barefoot…
      Most of the time it is about assumptions…
      Futhermore, I think therapist should start listen better to there patients/clients, get them involved instead of telling them what to do.
      And last but not least they should look for solutions and not for more problems… i.e. KISS: keep it simple ‘stupid’.

      Btw, I’m a Dutch Physical Therapist, and yeah love running on VFF….

      Reply

  2. Michael Spinks

    September 23rd, 2011 at 10:54 am

    Podiatrists are loving the barefoot/minimalist movement! Its creating so much work for them!

    Reply

    • Brian Patterson

      September 23rd, 2011 at 11:03 am

      How so?

      Reply

      • Matt

        September 23rd, 2011 at 12:11 pm

        people are jumping into barefoot running too fast and creating new injuries which they go running to the Dr’s and Podiatrists to treat.

        Reply

    • Jeff, PR2

      September 23rd, 2011 at 11:35 am

      Since I started wearing my Sprints my knees no longer hurt, my back no longer hurts, and I haven’t gotten a single ingrown toenail… so how is the minimalist movement helping them?

      Reply

  3. Alexander

    September 23rd, 2011 at 11:35 am

    I began running barefoot this summer, bought my pair of KSO and just began to run the new way. The improvement is actually impressive. Sometimes I had knee pain when I ran in my asics sneaker, i have no such thing nowadays, the pain in my hip is also gone despite now i am running a lot longer distances. I had a lot of ankle injuries while running in ordinary sneaker, never did i ever strain my ankle while running in VFF. Podiatrist’s position is a bit understandable, they want to be sure, they need evidences, however, there are NO evidences that proves that protection like cushioning prevent injuries. So, it is strange that they actually want protection on people’s shoes. However, I understand that development of all those cushioning technologies which do not work still cost money…

    Reply

    • Alexander

      September 23rd, 2011 at 11:39 am

      When is said barefoot i meant minimalistically )

      Reply

  4. cat

    September 23rd, 2011 at 12:02 pm

    i dont have much faith in them i was told that i would have to wear orthodics and i decided not to. i also have 2 knee replacments and have done 3 1/2 marathons this year and 1 3/4 marathon. i would not have been able to run had i not decided to run bare or in my vibrams my knee’s and my feet are stronger today bc of my barefoot/vibram running thank you very much , and i would never go back to runners again!

    Reply

  5. Matt

    September 23rd, 2011 at 12:08 pm

    There are some podiatrists who know the benefits and superiority of being barefoot like my friend Dr. Ray McClanahan in Portland OR. His website is nwfootankle.com and he is GREAT! Also if you have foot injury problems check out Egoscue (which yes is what I do). Egoscue treats the underlying cause of pain and injury without drugs, surgery, or manipulation and is based on correcting your posture and function through very specific exercises. check it out at http://www.egoscue.com and also the book Pain Free by Pete Egoscue

    Reply

    • Brian Patterson

      September 23rd, 2011 at 12:11 pm

      Hi Matt, thanks for your comments. We actually have written about Egoscue on this site: http://myfivefingers.wpengine.com/egoscue-review-chronic-pain-relief/

      Reply

      • Matt

        September 23rd, 2011 at 5:11 pm

        Yes I saw that when you originally posted it. Did you go through the therapy process with John? Did you just use the book? How has it gone? Did you see changes? I would love to hear about it.

        Reply

  6. Ike

    September 23rd, 2011 at 12:28 pm

    Does everyone remember when “health experts” told us all the best way to lose weight? They argued about walking, running, and the perfect heart rate. Now “they” say that heart rate zone’s really dont’ mean much. Meanwhile, everyone with common sense said that the key to losing weight was burn more calories than you consume. It seems like convention gets in the way of common sense.

    I got vff’s because of my ankles. I have rolled, twisted, sprained, and broken both my ankles, to the point that I couldn’t do anything athletic without braces on. I tried VFF’s because of the zero drop. Common sense told me that it is harder to roll an ankle on the ground than one on a heal. Wanted the “toe shoes” because common sense told me I would slide around less inside of a shoe that my toes are locked into. Low and behold, my ankles are doing great. Also found a lot of other benefits to the VFF’s, but that is my story

    Reply

  7. Erin

    September 23rd, 2011 at 12:55 pm

    It’s so similar to the weight-loss industry…..making things more difficult than they have to be. My foot is meant to touch the ground, not be insulated from it. I’m 35, bad knees/hips/ankles/feet. Traditional running shoes hurt my feet, make my plantar fasciitis flair up. No insert, orthotic or fancy shoe ever allowed me to run. Now I run 3 times a week!
    The health community hates anything that challenges their traditional thinking…..this is just another one of those things. Time for a little evolution for the Foot Docs!

    Reply

  8. Matt Ferguson

    September 23rd, 2011 at 12:56 pm

    Hi Brian – I think that there are a few big reasons why you are seeing resistance on barefoot/minimalist running from the podiatry community.
    i) They are definitely seeing a spike in injuries caused by people failing to transition properly from supportive shoes to barefoot. Your site & others do a good job trying the educate people on how to transition, but many just start pounding out miles and end-up in a world of hurt. Barefoot isn’t to blame, but podiatrists are seeing the bad results and they aren’t seeing the good results.
    ii) Going from highly supported shoes and ankle braces to actively strengthening your feet and ankles is a *huge* shift in mindset. We saw a somewhat similar debate when ‘core strengthening’ started to replace back braces & drugs, and to a lesser degree, the same debate is happening with ankle braces. People are slowly discovering that their feet are a vital source of support and strength.
    iii) There is not yet the critical mass of solid science to back barefoot/minimalist running – having strong feet and ankles is common sense and there are a few studies, but you aren’t going to ‘transition’ a medical discipline until there is a significant amount of data…. and lets be realistic, there are multi-billion dollar companies with a huge vested interest in keeping our feet supported and braced.

    Through social media we’ve had the good fortune of meeting some awesome podiatrists who are very open to our message of strengthening the feet & ankles, so we keep the dialogue rolling with them and hope that builds a rapport within the rest of their community.

    I think the best we can do is stay true to our beliefs, educate when we can, and be open to disagreement as a healthy part of the process.

    Reply

    • Brian Patterson

      September 23rd, 2011 at 1:10 pm

      Awesome points, Matt. Thanks for sharing.

      Reply

  9. Terral

    September 23rd, 2011 at 2:12 pm

    It may not happen quickly but I believe that when there is enough demand for minimal/barefoot friendly podiatrists they will either begin to re-think their viewpoints or they will just eventually fade away as new, more open minded doctors come into play.

    It’s a similar concept to natural selection.

    Reply

  10. Dr. Nirenberg

    September 24th, 2011 at 6:36 am

    As a podiatrist, I don’t think all podiatrists “hate” minimalist shoes. Most podiatrists believe that most feet need support, protection etc. This is what most have been taught. (I have written about the benefits of barefoot activity for a long time, and I wear VFFs)

    Reply

    • Matt Ferguson

      September 24th, 2011 at 10:47 am

      Dr. Nirenberg – I just visited your website and I encourage others engaged in this discussion to do so as well b/c you will definitely see a Podiatrist who is well-informed on the barefoot/minimalist discussion. Great resource.

      Reply

    • Brian Patterson

      September 24th, 2011 at 12:59 pm

      Hi Dr. Nirenberg, thanks for chiming in. We’d love to have your perspective in a guest post – I’ll contact you directly.

      Reply

  11. Michele

    September 27th, 2011 at 1:25 pm

    I was unable to find a “traditional” doctor to treat an ankle injury without prescribing drugs and orthotics. The injury did not involve any soft tissue tears, just hyper-extension and inflammation. I ended up having amazing results with accupuncture, and didn’t have to give up my VFF’s!

    Reply

  12. Victor

    September 27th, 2011 at 2:11 pm

    I had a chipped bone removed from my ankle Dec. 09. The chipped bone happened wearing regular shoes and this spring I switched to VFF’s with out any ankle trouble. I had an ACL knee injury as well and wearing VFFs has reduced the amount of knee pain I get while walking. My Orthopedic doctor has not said anything negative about the VFF’s.

    Reply

  13. Musashi

    September 17th, 2012 at 7:29 am

    My Physio loves my Vibrams and thinks they’re cool.
    This may be because he also teaches Yoga and Pilates, so he has an appreciation for barefoot training.
    Can’t take any credit for this, since I found my Physio by accident; but sensible physios do exist.
    I think podiatrists are running scared because bad feet are their bread-and-butter; Physios have plenty of other means by which to make a living.

    Reply

  14. Ken S.

    September 17th, 2012 at 11:34 am

    Podiatrists don’t understand it’s not the shoes that are a problem, it’s the technique used for running and walking that are the problem. However, they are not the only people with this misunderstanding.

    Reply

  15. Jim Haselmaier

    September 18th, 2012 at 8:27 am

    I don’t think it’s Podiatry that’s the problem, it’s closed-minded Podiatry that’s the problem. I’m fortunate in that my Podiatrist is a huge believer in the philosophy “the foot was meant to move”. He will use little pads, wedges and even orthotics TEMPORARILY to enable tissues to heal, but then has you get out of them. He says these devices are splint (or like a cast) in that sometimes parts of the body need temporary support to promote healing, but then get rid of them.

    The Barefoot Runners Society maintains a list of barefoot/minimalist friendly medical professionals: http://tinyurl.com/6mzq7du My gut is that some term will emerge, maybe even just informally, to describe this “more open” style of Podiatry.

    Jim

    Reply

  16. Hannah

    March 22nd, 2013 at 10:48 pm

    I am in the exact situation that you mention above: I believe strongly in minimal footwear and live a paleo lifestyle; I also have foot problems. I work a job that requires me to be on my feet for eight hours a day on cement and also requires some foot protection from heavy objects. In other words, no Vibrams at work. My current foot problem has progressed to the point where I limp almost all the time and have developed knee pain from the limp. I am young and active and cannot find a foot ‘doctor’ who takes my insurance and supports my paleo lifestyle. My experience with podiatry has so far left me with a bad taste in my mouth, but what options do I have?

    Reply

  17. Zac

    October 20th, 2013 at 2:51 pm

    It’s also important to remember that most people that podiatrists see are often elderly, overweight or injured. Our feet did evolve to run without shoe support, however the foot and ankle structure is not adapted for supporting an overweight body or running on concrete etc. So imo if someone is young and of a healthy weight then the extra stress put on feet by minimalist shoes can be beneficial if used cautiously. Podiatrists usually dont see folks that fit into the young and healthy category. I love my new balance minimus shoes but would never tell my grandpa to buy a pair.

    Reply

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